Publications by authors named "Steven A Greenstein"
Purpose: To report interim results of a single center, randomized, double-blind, crossover-controlled clinical trial comparing wavefront-guided (wfg) scleral lenses (SLs) to traditional scleral lenses (tSLs) for patients with a history of irregular corneal astigmatism (ICA).
Methods: Thirty-one ICA eyes of 18 participants were reviewed, 23 with keratoconus, six postcorneal refractive ectasia, and two postpenetrating keratoplasty. Patients with corneal or lens opacities were not excluded from participating.
Purpose: Keratoconus is a progressive disease characterized by changes in corneal shape, resulting in loss of visual function. There remains a lack of comprehensive understanding regarding its underlying pathophysiology. This review aims to bridge this gap by exploring structural failures and inflammatory processes involved in the etiology and progression of keratoconus.
View Article and Find Full Text PDFPurpose Of Review: To review corneal crosslinking for keratoconus and corneal ectasia, and recent developments in the field. This study will review the mechanism of crosslinking, clinical approaches, current results, and potential future innovations.
Recent Findings: Corneal crosslinking for keratoconus was first approved by U.
Background: Online physician reviews increase transparency in health care, helping patients make informed decisions about their provider. Language processing techniques can quantify this data and allow providers to better understand patients' experiences, perspectives, and priorities. The objective of this study was to assess patient satisfaction and understand the aspects of care that are valued by patients seeking refractive care using sentiment and word frequency analysis.
View Article and Find Full Text PDFPurpose: Determine the pediatric prevalence of keratoconus (KC) using Scheimpflug corneal tomography.
Methods: A prospective observational study was done on subjects aged 3 to 18 years at the Princeton Vision Clinic, Chicago, IL. Scheimpflug tomography (Pentacam HR, OCULUS Optikgerate GmbH) scans (Belin/Ambrósio Enhanced Ectasia BAD3) yielded BAD Final D (Final D) and Back Elevation at the Thinnest Point (BETP) measurements.
Objectives: To report on baseline refractive and keratometric values and their correlation with tomographic characteristics of eyes with keratoconus (KC).
Methods: Retrospective chart review of patients treated in a single-center cornea and refractive surgery practice. Baseline topographic measurements were reviewed for 1,012 keratoconic eyes of 586 patients between 2008 and 2018.
In this report, we discuss contact lens (CL) fitting in a patient with a history of keratoconus (KC), before and after undergoing topography-guided photorefractive keratectomy (TG PRK). Before TG PRK, the patient failed multiple CL modalities and reported difficulty with his habitual CLs and inadequate spectacle-corrected visual acuity to perform his activities of daily living. In this case, a collaborative, comprehensive approach to visual management in a patient with KC was used, and after TG PRK was performed to improve his corneal contour and symmetry, our patient was fit with a standard soft CL and additionally had improved spectacle-corrected visual acuity.
View Article and Find Full Text PDFObjectives: To report on the topographic and visual outcomes 10 years after corneal cross-linking in patients with progressive keratoconus and corneal ectasia after refractive surgery.
Methods: Cross-sectional cohort study of an original, prospective, randomized, clinical trial. Patients treated in a single center cornea and refractive surgery practice as part of the U.
Purpose: To evaluate the utility of EQIP as a novel tool for determining the quality of patient information on YouTube regarding refractive eye surgery.
Methods: Three searches were conducted on YouTube using "PRK eye surgery", "LASIK eye surgery", and "SMILE eye surgery". 110 relevant videos were evaluated using the Ensuring Quality Information for Patients (EQIP) criteria.
Purpose: To report results of Corneal Tissue Addition Keratoplasty (CTAK) for keratoconus (KC) and ectasia after laser in situ keratomileusis.
Setting: Cornea and refractive surgery practice.
Design: Single center, prospective, open label clinical trial.
• POCUS is increasingly being used in the evaluation of critically ill patients. • POCUS can shorten pulse check duration and prognosticate outcomes in cardiac arrest. • POCUS can identify the etiology of cardiac arrest after the first image.
View Article and Find Full Text PDFThis case reports on the use of wavefront-guided (wfg) optics on custom ocular impression-based scleral lenses (IBSLs) for visual improvement in a patient with keratoconus (KC). A 28-year-old man with KC, who had previously failed a traditional, diagnostically fit scleral lens (tSL), was fit with IBSLs with traditional optics. Using a system that included a dot matrix on the IBSL and a wavefront aberrometer with pupil and dot registration software, a wfgIBSL was created.
View Article and Find Full Text PDFPurpose: To report on the use of scleral lens therapy for a patient with lipid keratopathy secondary to rigid gas permeable contact lens wear and ocular surface disease.
Methods: Case report and literature review.
Results: A 40-year-old man with a history of keratoconus and rigid gas permeable contact lens wear, resulting in corneal neovascularization and lipid keratopathy.
Purpose: The multicenter studies reviewed were designed to evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of progressive keratoconus and corneal ectasia after laser refractive surgery. The results of these studies led to approval by the United States Food and Drug Agency for both conditions in 2016. This paper reviews these studies, as well as single-center substudies investigating other aspects of crosslinking outcomes.
View Article and Find Full Text PDFObjectives: This case reports on the use of scleral lens therapy for a patient with a descemetocele secondary to exposure and neurotrophic keratopathy.
Methods: Case report and literature review.
Results: A 31-year-old man had undergone emergency surgery to repair a ruptured arteriovenous malformation resulting in left facial and trigeminal nerve palsies.
Purpose: To assess anterior corneal higher-order aberrations (HOAs) after corneal crosslinking (CXL) and intrastromal corneal ring segments (Intacs) used adjunctively.
Setting: Cornea and refractive surgery practice.
Design: Prospective, randomized clinical trial.
Purpose: To quantitate corneal haze and analyze the postoperative time course of corneal haze after transepithelial corneal collagen cross-linking (TECXL) in patients with keratoconus.
Methods: Patients underwent TECXL and were randomized into 2 groups. One group received intraoperative riboflavin 0.
Purpose: To assess outcomes of corneal crosslinking (CXL) and intracorneal ring segments (ICRS) (Intacs) used adjunctively, and then compare the safety and efficacy of concurrent versus sequential surgery.
Setting: Cornea and refractive surgery subspecialty practice.
Design: Prospective randomized clinical trial.
Incidence and associations of intracorneal ring segment explantation.
J Cataract Refract Surg
February 2019
Purpose: To assess the incidence and motivating determinants of explantation of intracorneal ring segments (ICRS) (Intacs) used for the treatment of keratoconus and corneal ectasia.
Setting: Cornea and refractive surgery subspecialty practice.
Design: Retrospective case series.
Purpose: To determine preoperative patient characteristics that may predict topography and visual acuity outcomes of corneal collagen crosslinking (CXL).
Setting: Cornea and refractive surgery practice.
Design: Cohort study.
Purpose: To assess the effect of preoperative topographic cone location on 1-year outcomes of corneal collagen cross-linking (CXL).
Methods: In this prospective, randomized, controlled clinical trial, 99 eyes (66 keratoconus, 33 ectasia) from 76 patients underwent CXL. Cone location was defined by the coordinates of preoperative maximum keratometry (maximum K) using the anterior sagittal curvature topography map (Pentacam, Oculus Optikgeräte GmbH).
Higher-order aberrations after corneal collagen crosslinking for keratoconus and corneal ectasia.
J Cataract Refract Surg
February 2012
Purpose: To determine changes in higher-order aberrations (HOAs) after corneal collagen crosslinking (CXL).
Setting: Cornea and refractive surgery practice.
Design: Prospective randomized controlled clinical trial.
Purpose: To investigate the in vivo, corneal, biomechanical changes after corneal collagen cross-linking (CXL) using the Ocular Response Analyzer (ORA) in patients with keratoconus and post-laser in situ keratomileusis (LASIK) ectasia.
Methods: Single-center, prospective, randomized, controlled, clinical trial. After CXL (69 eyes, 46 keratoconus and 23 post-LASIK), corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ORA and analyzed in a treatment, sham control, and fellow eye control group at baseline and 1, 3, 6, and 12 months.
Purpose: To evaluate changes in corneal topography indices after corneal collagen crosslinking (CXL) in patients with keratoconus and corneal ectasia and analyze associations of these changes with visual acuity.
Setting: Cornea and refractive surgery subspecialty practice.
Design: Prospective randomized controlled clinical trial.